Radiation therapy for metastatic disease involving the orbit.

A series of 47 patients with clinically demonstrated metastatic disease to the eye were evaluated for treatment with radiation therapy. Of the 37 patients who completed treatment, 88.9% responded with demonstrated tumor regression and improvement of symptoms. The breast and lung remain the two most common sites of origin for metastatic disease involving the orbit although the reason for this remains undetermined. The most common site of orbital involvement is the posterior choroid and no predilection for involvement of either the right or left eye could be determined. Radiation doses in the range of 3000-4000 rad delivered over a 3- to 4-week period of time, with care being taken to spare the lens, is recommended. Aggressive radiation therapy is indicated when the eye metastasis occurs without systemic disease or with stable systemic disease. The median survival in this group of patients was 8.5 months in those patients in whom adequate follow-up information was available.